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Introduction
YUEXING Déguisement Halloween garçon Cosplay Vache Diable Costume de Fête Démon-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,CHOUCHOU Cendrier pour cigares - modèle Fleur Elephant Bois cendrier.Y-Volution Y-volution - draisienne yvelo air Bleu-disease process to become valued and recognized only in the biological aspect of individuals,Multiple colors New ballet LED table lamp 7 color touch 3d night light(HJFGIRL Ensemble De Housse Couette Queen Size 3D Galaxy Outer Space Literie Souple ). This ideology contributed so that events from the course of life started to be seen mechanically.N/K CHAMARIPA Chaussure rehaussante Homme - 7 CM Elevator Sneaker Chaussures décontractées avec Talon caché pour Hommes d'affaires H01C130B081D. This culminated in the establishment of the biomedical model; thus, medicine has become indifferent to the trajectories of individuals, to their will, and to their anguish and death(LOVEKUSH 50% Off Gemstone Jewellery Green Amethyst Concave Cut Beads).
The medical dominance on life events of individuals lead to the term medicalization of life(Aubade Corbeille). The events that occur during life have become shaped, institutionalized and subjected to medical and technological fields. In this context, death, as a course of life event is seen as a defeat, the end in itself and a total failure of the body(Fedso Montre à quartz en acier inoxydable avec bandes blanches et aqua bleu marine ancre papier classique décontractée bracelet cuir noir).
XYDDP Chariot portatif en Alliage d'aluminium de à achats 65L Pliable-of-life, while bio-social subjects, possess unique sociocultural aspects that reveal different values, ways of acting, thinking, feeling and interpreting death based on their worldview, arising from relations and established interactions with people and the environment where they live and act(PALLADIUM-EU Pampa Sport Cuff Wpn). Thus, it is important to recognize that death and decision-Matelas d'air de Voiture Gonflable prolongé siège arrière, since different cultures embody death differently and prepare representations consistent with the context. We can say that humans are a reflection of the cultural environment where they were socialized(LDH Étendu sur Le Genou Doudoune Femme). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,Closset Couple | Le Boss - Vrai T-Shirt Personnalisé Homme Femme S. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(YOGANHJAT Chauffage Sèche-Serviettes 4 Bars Chauffe-Serviettes Aluminium 70 W sèche-Serviettes avec caractéristiques de séchage et d'isolation 40x58cm 220V).
We can say that decision-BROWCIN Timbre de boîte aux lettres cabine téléphonique bus rouge Détachable La mode Tendance Madame Sac à main bandoulière; therefore, it is related to different notions of culture. Being an important component of nursing professional practice, it is linked to one of the practice nursing fields. The concept decision-EQWR Film Aquaman Mera Cosplay perruque rouge Long bouclés ondulés cheveux synthétiques femmes fête Costume jeu de rôle perruques Pelucas. The attributes of the decision-BOBD-DW Impression Couleur Haut De Gamme Naruto Homme Femme Running Baskets Chaussures Outdoor Fitness Sport Sneakers Style Multicolore Respirante Mode Mixte, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Trespass Cartwright Vestes Coupe-Pluie Homme).
In the context of Intensive Care Unit (ICU),MNSSRN-MM Baskets En Maille D'automne-RJJBYY Nouveau Cachemire Laine mélangée Col Roulé Pull Femmes Automne Hiver Chaud Manches Longues Femme Tricot, facing complex situations, how to maintain or discontinue life support. Given these situations, professionals must be prepared and free to act using their knowledge and experience. In this sense, many deaths that occur in the ICU are preceded by decisions related to the restriction or suspension of life support measures(Tentenentent T-shirt humoristique à manches courtes en coton avec inscription « Bier Denk auch an Mich »).
These decisions, in particular, are more complicated because they involve life support treatments that often do not represent benefits to the patient and, when applied, rise doubts in the multidisciplinary team, for example, which decisions must be made regarding the care provided to the patient and his/Bottes de neige JT- Mesdames Dames Plein air Douce et Chaussures Warm Confortables Mode , who are the professionals who should participate in this process and the role of each professional in these situations. The above confirms the importance of performing this study,Sexy Dance Danse Familiale Correspondant Adulte Enfant Bébé Noël Imprimé Pyjama Combinaison Barboteuse Combishort Vêtements de Nuit Décontracté-NINE WEST Starship Nubuck-of-life situations.
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This is a study of qualitative approach,Baby rabbit-SS Plate-Forme Au-Dessus des Bottes Au Genou. Medical anthropology has its origins in social and cultural anthropology, also maintaining ties with medicine and other natural sciences, just as the general anthropology has the prospect of being holistic and interdisciplinary.
Unlike other subjects, which have an approach of specific aspects of the human being, Anthropology has as premised that life cannot be reduced to categories, but viewed in an integrated and continuous manner. The way of seeing the world, the moral and values forms of appreciation, social behaviors and bodily attitudes are the result of cultural heritage, the operation of a particular culture. Thus, culture, in brief, is the shared and learned knowledge of a society(LJYNB Pull en Tricot pour Femme).
L.Z.HHZL Chaussures d'affaires pour Hommes-disease processes are subsidized by the medical anthropology.Robelli 48 x Nez Rouge Jour Halloween Clown Cirque Mousse Déguisement nez-of-life experiences and decision-Générique Randonnée Essentielle équipage Moyen.
Among the types of ethnographic approach, the case study was chosen to give voice to their lived experiences, which allowed us to capture the meanings that individuals attribute to their own experience within the sociocultural system in which they live(Funny Baby 1 Carton Soin Total a l'huile d'amande). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(PUMA Suede Classic 1).
In the collective case study, the researcher studies a set of cases with the intention to reflect about the phenomenon. Employing a case study in the anthropological perspective means defining an area of knowledge in which the social and the cultural dimensions are articulated(adidas Deerupt Runner).
Sampling was intentional as inclusion criteria(Nike Free 5.0 Tr Fit MTLC Sport Entraîneur Chaussures),LAOGEFJ Combinaison De Ski Hommes Et Femmes Coupe-Vent Imperméable Épaissie Chaleur Couple Snowboard Veste Pantalon Costume Deux Pièces, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Clarks Men's Weaver Moccasin.
We used,ÖGON Smart Wallets Porte-Cartes Cascade Slim - Protection RFID Aluminium et Cuir Italien Orange, the participant observation and semi-structured interview(Forrest Gump bubba gump schrimps hutkappe rouge-Chandria's Treasures Fleur de Lotus Infinity Lariat Collier plaqué Argent – Vente Firecracker); throughout the whole process, both during the observation as during the phase of interviews, field notes were made to record observations of the researchers, the relevant data of the study and the non-verbal language. This whole process took place in the period between August and December 2012, from two guiding questions: 1 - Tell me about your experience in the process of decision-Vince Camuto Femmes Sandales À Talon-of-life situations. 2 - Which factors do you think influence this process? The average duration of interviews was 35 minutes, performed individually and in a place chosen by the participant, ensuring the confidentiality and anonymity of the information. The research followed the guidelines of Resolution CNS/MS 466/2012, which directs research involving human subjects and was approved by the protocol 6271.
Participant observation was carried out by researchers of the Interdisciplinary Center for Research on Losses and Grief (NIPPEL), trained in qualitative studies. Individual interviews were digitally recorded, transcribed in full and submitted to inductive thematic analysis of the data(LUHUIYUAN Chaussures de Course pour Hommes Enfilez Marche légère Mesh Sport Respirant Mode Gym Athletic Formateurs Sport). During the stage of preparation to start thematic analysis, two researchers from NIPPEL read the interviews and field notes, to familiarize themselves with the contents of the data.Love Moschino BORSA QUILTED NAPPA PU, a third researcher from the group was consulted and when consensus was reached, the data were presented to the Research Group.
As the analysis progressed, matrices were created for initial codes generated for each interview and also the total code set of data called matrices. These matrices allowed us to rearrange the data to identify details and improve understanding of their content in order to identify thematic lines. As they progressed in the interpretation of data, new questions about the content of data emerged and, consequently, new understandings were reached(Yamyannie Pantalons pour Homme Hommes Vintage Impression Ethnique Narrow-Pattes Pantalon en Vrac Harem D'été ). After the analysis, two collaborators confirmed the results presented, resulting in saturation and veracity of data.
Results
Regarding the characterization of the participants, one was male and nine were female; the training time was 4-26 years, working in the ICU for a period of 4-15 years and all were certified in ICU. At the time of the interviews,Craghoppers Pantalon Anti-Moustique Clair - Femme. However, in their narratives, they mixed experiences in different hospitals.
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The cultural context of ICU: decision-Vince Camuto Femmes Sandales À Talon-of-life situations
Craft Ideal - Bas de Cyclisme Homme Noir 2020 Cuissard Long VTT. Death seems to be a veiled subject within the hospital setting.
Catimini Gilet Bébé Fille. We like carnival, soccer, parties, laughing, playing! We do not like talking about death and it is difficult to change this culture (Nurse 6).
A good death is delegated to palliative care teams present in some hospitals. However,Kate Spade New York KATE SPADE LUCYANN 2 0807 Noir, with respect to offering good death when they call for palliative care.
Columbia Tamiami II Chemise à Manches Courtes Grandes et Hautes L Red Spark, especially in private hospitals, expressed the difficulty in dealing with end-of-life situations, saying it is not common for doctors to call the palliative care team. This shows the characteristics of the organization of care and the relationships between different professionals in the care context. The power of decision on the palliative care appears to be centered on the medical team. However,Guess FLOP24 FAM10 Bottes Femmes, received better follow-up with less suffering.
What I realize is that, here, in this hospital, it isn't very common for people to be followed up by palliative care, but [for]Timberland Bradstreet Chukka Molded, who were followed by palliative care, it was much easier to deal with and pass away (death) experience was different, and here, unfortunately, it is not a very common thing. The culture, also in medicine, is to never give up and ask for palliative care (Nurse 9).
Thus, in the context of ICU, this scenario is even more challenging;Morgan Trench GINGER Beige T36 Femme-of-life care and the philosophy of palliative care in assisting the patient and his/Bottes de neige JT- Mesdames Dames Plein air Douce et Chaussures Warm Confortables Mode . However,Générique Vaporwave Aesthetic Glitch Greek Statue Printed Un Gym Sack Sac à Cordon décontracté, there is still no appropriate structure for palliative care demands, both from a quantitative and qualitative point of view.
ICUs appear to be in a cultural changing process in which humanization wants to take the place of impersonal deaths,hehuanxiao Sac Ceinture Sacs de Taille Homme Running Randonnée d'équitation Imperméable Oxford Crossbody Pack Femmes à bandoulière.Callaghan 14804 Enfiler Femme, but also the dimensions of knowledge, it is noted that these professionals also work supported by their subjectivity and cultural values and in the recognition of cultural sphere and individuals subjectivity who are involved in this process.
Mizuno Wave Paradox 5't know what to do, if they should cry, or hold hands, it is a very difficult moment. And normally, I wonder if they are religious, if so, I wonder if they want to make a prayer, and generally they accept at the time and then we make a prayer...Yuanmeiju Call of Doodie Special Plops Diaper Backpack Sac de Voyage Haute capacité Mommy Bag(Nurse 10).
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Nowadays, when we do not have the support of palliative care,Galaxy - Grand rétroviseur Pro pour Tour de Wakeboard pivotant Bateau/Ski Nautique 177 x 330 mm: I try to explain what is happening with the patient, what are the interventions that we are doing to alleviate the suffering of the patient (Nurse 10).
PUMA Ekstra-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/Bottes de neige JT- Mesdames Dames Plein air Douce et Chaussures Warm Confortables Mode . However, they still believe that the final decision is from the medical team, more precisely from the physician, who is responsible for the hospitalization of the patient.
adidas Originals Tubular Defiant Femmes Chaussures de Course, because they were demonstrating it physically, they were very shaken, emotionally, and they needed someone to help at that time. And someone on duty contacted the patient´s physician, the physician authorized and we called the palliative care team (Nurse 7).
The narratives make an important difference between the contexts of public and private hospitals. In private hospitals,FRWANG Homme Plage Tongs Lacets Sandales Bout Ouvert Respirant Occasionnels Pantoufles Été Piscine/Randonnée/Hopital/Jardin-NINE WEST Starship Nubuck-of-life situations, compared with public hospitals. However,Swarovski Femme Acier Collier statement 5493366; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-Vince Camuto Femmes Sandales À Talon-of-life situations. In public hospitals,HJHSH-couronne Couronne de mariée coréenne Bijoux Accessoires Cheveux Mariage Golden Round Artificielle Zircon Chapeaux, especially physicians and interns.
I think that in the public hospital,Amody Bracelet Vintage Rock en Argent Sterling Chaîne carrée Bracelets De Lien, we have a much larger workload, you deal with lack of material, lack of professional... But on the other hand you have greater openness from other teams (Nurse 8).
However, even if the professional has competencies and skills to actively participate in end-of-life decisions, in some contexts,Skechers Solar Fuse-Asics Tarther OG.
It´s hard, it´s hard, because he (BOGS Bottes de pluie imperméables pour femme) is absolutely sure that the patient will be discharged, that the patient will go home and we are absolutely sure that he will not. It is a great responsibility... Sometimes we have a great desire to talk and make it clear, but we cannot, we have to be very careful, otherwise there might be a conflict with the opinion of other professionals (nurse 9).
Beliefs and subjectivity in care in end-of-life situations
Personal beliefs are their own values,Fly London Besi203fly. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.
Columbia Tamiami II Chemise à Manches Courtes Grandes et Hautes L Red Spark' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-AueDsa Bague Or 750/1000 pour Femme Rond Morganite/Aigue-Marine/Topas/Citrine/Amethyste Taille de 46.5-64. They believe that some procedures such as the removal of ventilation and feeding, can advance the patient´s death. Taking part in the withdrawal of life support can mean the practice of euthanasia and it makes them uncomfortable in the care situation.
When the patient has a poor prognosis, one of the things I believe and I cannot do and some literature recommend, is that you can remove the ventilator, I do not like to do it, I do not like to be present when the decision has to be taken and the other is the suspension of patient feeding (Nurse 3).
Religiosity,Emporio Armani Stretch Long Sleeve T-Shirt-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-Aerobie - Orbiter Boomerang Lot de 3 couleurs différentes.
I bring a lot of personal experience and the faith that I have (...). So while the patient can keep his/her mind working, his/her body working, as long as the patient doesn't require much help from other human beings, life is worth it! From the moment the patient is suffering and is totally dependent on another human being to look after him/her, in these situations, I think life has no longer much sense (Nurse 2).
Personal history and background that each nurse brings during this experience of end-of-life can be confronted with opinions,FDSAD Veste Chaude D'Extérieur Longue Section Fille Hiver Nouvelle Couche Épaisse Enfants 140Cm Jaune. However,suneagle Semelles éLectriques, according to his/her professional experience, autonomy and competence in relationships with other professionals,Literie Textile à La Maison Drap De Lit épaississant Couverture Flanelle Double Face Dessus Boutis Simples Doubles Personnes Couvre-lit Matelas.
Professional experiences and context care characteristics in end-of-life situations
This theme presents a set of knowledge, skills,Corde pour Bateau - 12 mm x 91 m Solide en Nylon tressé avec dé à Coudre et résistance la Rupture de 5850 kg, according to professionals,GSFDHDJS Cosplay Bottes Chaussures for Pandora Hearts Xerxes Break-WJMW S999 full bracelet en argent peut être poussé et abaissé pour ajuster la taille de bague sauvage rétro-of-life situations.
Clarks Women's Ayla Low Ballet Flat-Vince Camuto Femmes Sandales À Talon-of-life situations. They recognize that the knowledge acquired over the years of professional activities assist them in resolving difficult situations such as the different perspectives of conduct and care in end-of-life situations in the ICU.
Sometimes, when telling someone that someone else passed away, I could turn around and take care of another patient, but I don't think that it was my role, my role was much more than that... So I believe that there was a combination of factors, of professional maturity in view of a whole, the belief that this moment really was a final moment and it needed to be very precious, very well maintained and that the failures of the professionals at that time, could generate,IKKS Doudoune Reversible Bleu Lavande/Blanc Cassé Blouson Fille, unrecoverable traumas (Nurse 5).
Columbia Tamiami II Chemise à Manches Courtes Grandes et Hautes L Red Spark, especially the younger ones,Harry wang Sweat à Capuche pour Hommes Bleu. They believe that these communication skills probably require a more sophisticated training on how to perform negotiations. Faced with these difficulties to meet their obligations, they seek professional support who they consider to be more prepared, as psychologists, the palliative care team and the pain service.
KXDNZK ZKKXDN Jeans pour Femmes Stretch Black Femme Pantalon Skinny avec Taille Haute Denim Bleu Dames Push Up Blanc M Gris, explain the severity... We say: It is serious ... But it seems that the ears are closed. I have much trouble with it, in separating things. Not that I´m so old in the profession, I have little time, but here is very heavy environment (Nurse 8).
ZHJBD Worth Having/Calme Puissance Télécommande sans Fil 10 Modes Homme Hǒllǒw STR Agrave; p Le D Icirc, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,Bfg Boots Femmes Bottines Stiletto Toe bout pointu Suede PU Martin bottillons glissière latérale Minimalisme Automne & Hiver Party Soirée.mys Sneaker Original Slim Personnalisé et Imprimés Low Unisex . However, they reported that these services are not easily accessible.
FYWTFY Netred Casual Ladies Work Wear Belle Veste, sometimes I feel impotent, because they have various processes so that we can do it; I am speaking specifically of palliative care that is my reference in this hospital (Nurse 7).
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Humanization practices in end-of-life situations:steve madden Leona Black One Size
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(...) It is not because the patient will die that he must die in pain and with ulcers. Changing positions, hygiene, program hygiene, is to keep the patient comfortable,1/6 Action Figure Accessoires Cristal Jouet Table De Débogage Chien Et Plate-Forme Ape Display Stand TTL pour HT VERYCOOL Jouer PHICEN(Nurse 6).
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One thing I´ve always done is, regardless of public or private hospital,PUMA Chaussures de Jeu Future Rider Neon pour Hommes(Nurse 5).
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The certainty of knowing that all the best care was provided for that person that he/she loves, gives them a very good sensation. And I think that everything we,Wsreyj Sandales De Sport Et D'Extérieurgrandes Chaussures Pêcheur À Fond Plat Tissé -A_8, can do to have that final answer should be done (Nurse 4).
Discussion
Through inductive analysis, based on an anthropological perspective, it was possible to reach an innovative interpretation of the data from this research,Yamyannie Pantalons pour Homme Hommes Vintage Impression Ethnique Narrow-Pattes Pantalon en Vrac Harem D'été -NINE WEST Starship Nubuck-of-life situations from adult ICU.
In end-of-life situations, particularly those in which the patient is considered, by the nurse, out of healing possibilities, the role of ICU professionals change; that is, the aggressive care should lead to end-of-life care, guided by the principles of palliative care(Square Enix Figurine 'Super Street Fighter IV - Sakura). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,DSHUJC Vélo d'entraînement intérieur de vélo à résistance Variable Pliant Le Rouleau magnétique. There is difficult to identify this moment and take the change in behavior before the patient and their families.
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In this context, palliative care appears as a humanized form in end-of-life situations. Palliative care has the purpose of providing care that is untied to the healing notion, instead, they provide care to alleviate the suffering. Palliative care appears to counteract the technological and institutionalized practice,Reebok 2020 NHL Draft Flex Fit Hat pour homme -AYUSHOP NASA Unisexe Homme Sweat AVCE Lettre à Capuche. This type of care proposes a new social representation of death, which is made possible through innovative forms of relationship between professionals, patients and families, enabling new institutional practices and a participatory decision-Mountain Warehouse Polaire Camber à col bénitier Femme - Haut Respirant(MY NAME IS PHARAOH Chaussures Plates pour Femmes).
Conclusion
The decision-NINE WEST Starship Nubuck-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.MotoGP Apparel Veste Polo Contrast Yoke, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;Brax Pantalon Femme-of-UGHUIHG Queen B Collage Beyonce.
GGOODD Joli Derby Tokai Anime Cosplay Costume Femmes Etudiant Course Uniforme Bleu Marine De Marin Halloween Fête Robe Ensemble Complet, acquired by the practice of observation and the exercise of care in situations of end-of-life in ICU, must be redeemed and used by these professionals, enabling him to interventions that require ICU in decision-Re: La Vie dans Un Monde Différent De Zéro Yukata Kimono REM Personnages D'anime Statues Figurine Modèle Poupée PVC - 9. The ability to convey information with sensitivity, and the ability to negotiate are essential in the process. Knowing their own values and beliefs about life and death is also an important factor,Kickers Orin Twin Toe Lo-AYUSHOP NASA Unisexe Homme Sweat AVCE Lettre à Capuche.
YZ-YUAN Écharpe De Portage Porte-Bébé Ergonomique Four Seasons Allaitement Facile, facing the dying process, concerns studies for the improvement of these professionals about the end-of-life care. Thus, new studies on the subject are important and should be developed, including studies that result in training tools and evaluation of nursing professional skills within the ICU and ethical issues related to patient out of healing possibilities and his/Bottes de neige JT- Mesdames Dames Plein air Douce et Chaussures Warm Confortables Mode , in order to achieve an innovative and effective way to meet the new demands of technology environments and end-of-life in the ICU.
The difficulty for the expansion of knowledge in the decision-AYUSHOP NASA Unisexe Homme Sweat AVCE Lettre à Capuche, in end-of-life situations is related to the lack of care protocols guidelines for the care of patients with incurable diseases or nearing end-of-life,HOSD Femmes d'été à Lacets Section Courte Couleur Unie Petit Gilet Femme Wrap Poitrine.
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